School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, K1N 6N5, Ottawa, Ontario, Canada.
Present affiliation: Faculty of Kinesiology, University of Calgary, Alberta, Calgary, Canada.
BMC Neurol. 2021 Aug 4;21(1):300. doi: 10.1186/s12883-021-02280-y.
Executive functioning (EF) deficits are troubling for adolescents and young adults (AYAs) after cancer treatment. Physical activity (PA) may enhance neural activity underlying EF among older adults affected by cancer. Establishing whether PA enhances neural activity among AYAs is warranted. As part of a two-arm, mixed-methods pilot randomized controlled trial (RCT), this proof-of-concept sub-study sought to answer the following questions: (1) is it feasible to use neuroimaging with EF tasks to assess neural activity changes following a 12-week PA intervention? And (2) is there preliminary evidence that a 12-week PA intervention enhances neural activity among AYAs after cancer treatment?
AYAs in the pilot RCT were approached for enrollment into this sub-study. Those who were eligible and enrolled, completed functional magnetic resonance imaging (fMRI) with EF tasks (letter n-back, Go/No Go) pre- and post-PA intervention. Sub-study enrollment, adherence to scheduled fMRI scans, outliers, missing data, and EF task performance data were collected. Data were analyzed with descriptive statistics, blood oxygen level dependent (BOLD) analyses, and paired sample t-tests.
Nine eligible participants enrolled into this sub-study; six attended scheduled fMRI scans. One outlier was identified and was subsequently removed from the analytical sample. Participants showed no differences in EF task performance from pre- to post-PA intervention. Increases in neural activity in brain regions responsible for motor control, information encoding and processing, and decision-making were observed post-PA intervention (p < 0.05; n = 5).
Findings show that fMRI scans during EF tasks detected neural activity changes (as assessed by the BOLD signal) from pre- to post-PA intervention. Results thus suggest future trials confirming that PA enhances neural activity underlying EF are needed, though feasibility issues require careful consideration to ensure trial success.
clinicaltrials.gov, NCT03016728. Registered January 11, 2017, clinicaltrials.gov/ct2/show/NCT03016728.
执行功能（EF）缺陷是癌症治疗后青少年和年轻成人（AYA）的一个问题。身体活动（PA）可能会增强受癌症影响的老年人大脑中 EF 的神经活动。有必要确定 PA 是否会增强 AYA 的神经活动。作为一项双臂、混合方法试验性随机对照试验（RCT）的一部分，这项概念验证子研究旨在回答以下问题：（1）使用 EF 任务的神经影像学来评估 12 周 PA 干预后的神经活动变化是否可行？（2）是否有初步证据表明 12 周 PA 干预可以增强癌症治疗后 AYA 的神经活动？
向 RCT 中的 AYA 参与者提出了参与该子研究的邀请。符合条件并参与的参与者在 PA 干预前后完成了 EF 任务（字母 n 回，Go/No Go）的功能磁共振成像（fMRI）。收集了子研究的入组情况、对预定 fMRI 扫描的依从性、离群值、缺失数据和 EF 任务表现数据。使用描述性统计、血氧水平依赖（BOLD）分析和配对样本 t 检验对数据进行了分析。
9 名符合条件的参与者入组了该子研究；6 人参加了预定的 fMRI 扫描。发现了一个离群值，并随后从分析样本中删除。参与者在 PA 干预前后的 EF 任务表现没有差异。在 PA 干预后，负责运动控制、信息编码和处理以及决策的大脑区域的神经活动增加（p<0.05；n=5）。
研究结果表明，EF 任务期间的 fMRI 扫描可以检测到 PA 干预前后的神经活动变化（通过 BOLD 信号评估）。因此，结果表明需要进行未来的试验来确认 PA 增强 EF 背后的神经活动，但可行性问题需要仔细考虑，以确保试验成功。
clinicaltrials.gov，NCT03016728。2017 年 1 月 11 日注册，clinicaltrials.gov/ct2/show/NCT03016728。
